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66 and analyzed by the Division of Criminal Justice. In 2000, NIJ changed its procedures from a convenience to a probability sample. Thus, no ADAM data trend analysis is presented. Rather, 2001, 2002, and 2003 use percentages by drug type are indicated. • Sentencing data on Federal drug convictions in the State of Colorado for Federal FY 2002 were compiled by the United States Sentencing Commission, Office of Policy Analysis. • Information about offenders in the Colorado correctional system for substance abuse-related crimes was supplied by The Colorado Department of Corrections, Overview of Substance Abuse Treatment Services Fiscal Year 2003 and by The Colorado Department of Corrections Statistical Report, Fiscal Year 2003. • Statistics on seized and forensically analyzed drug items were provided by the Drug Enforcement Administration, Office of Diversion Control, National Forensic Laboratory Information System (NFLIS) Year 2003 Annual Report, from information reported by the Denver Police Department Crime Laboratory. • Alcohol data were taken from the “U.S. Apparent Consumption of Alcoholic Beverages Based on State Sales” by the U.S. Department of Health and Human Services, June 2004, the Rocky Mountain Insurance Information Association (RMIIA), the Department of Transportation Fatality Analysis Reporting System (FARS), and Colorado State Patrol statistics. • Tobacco statistics for 2003 were provided by “Colorado Health Watch 2004,” a publication of the CDPHE. • Population statistics were obtained from the Colorado Demography Office, Census 2000 including estimates and projections, and factfinder.census.gov. • Qualitative and ethnographic data for this report were available mainly from clinicians from treatment programs across the State, local researchers, and street outreach workers. DRUG ABUSE PATTERNS AND TRENDS Cocaine/Crack Cocaine indicators remained mixed, with some increasing and some decreasing. EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Denver and Colorado Unweighted data accessed from DAWN Live! on Denver ED reports for cocaine showed 699 such reports in the first half of 2004, representing 41.4 percent of all illicit drug reports (exhibit 1). Statewide hospital discharges showed that cocaine mentions per 100,000 population rose steadily from 1997 (56 per 100,000) through 2003 (80 per 100,000) (exhibit 2). The number of cocaine-related calls to the RMPDC rose statewide from 2001 (59) through 2003 (68), and during that time period cocaine was the most frequent drug of concern (second only to alcohol) (exhibit 3). In 2004, however, the number of calls regarding methamphetamine (66) exceeded those for cocaine (59). Cocaine-related mortality data for the Denver PMSA showed an increase from 68 such deaths in 1996 to 126 in 2001 (exhibit 4). Cocaine-related deaths then declined slightly in 2002 to 108. Throughout this entire time period, cocaine-related mortality was higher than the mortality for any other drug in the area. Statewide, cocaine deaths climbed from 92 in 1997 (23.6 per million) to 146 in 1999 (36.1 per million). While they declined to 116 in 2000 (27 per million), they increased again to 134 in 2001 (30.4 per million) and to 153 in 2002 (34.1 per million). Data from 2003 show 179 cocaine deaths (39.2 per million), the highest number and rate in the time period indicated. Reports from clinicians, researchers, and street outreach workers around the State corroborate the continuing cocaine problems reflected in the indicator data. However, qualitative reports indicate a shift to methamphetamine among some stimulant users. Cocaine was the primary drug for 20 percent of all treatment admissions (excluding alcohol) for the first 6 months of calendar year 2004 (annualized) (exhibit 5). Marijuana and methamphetamine exceeded cocaine as the primary drug during this time period, representing 39 and 26 percent of admissions, respectively. In 2002, cocaine as a primary drug accounted for 20 percent of all drug admissions, exceeding methamphetamine (19 percent). In 2003, admissions with methamphetamine as primary drug (23 percent) overtook those reporting cocaine (20 percent). The majority of cocaine clients in treatment had been using this drug for longer than 3 years. The proportion of “new” cocaine users entering treatment, defined as those admitted to treatment within 3 years of initial cocaine use, remained stable from 1997 (17 percent) through 2004 (18 percent) (exhibit 6). It Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005
takes an average of 10 years after first use for the majority of those users with cocaine as their primary drug to seek treatment (exhibit 7). The percentages of clients who smoke cocaine declined steadily from 65 percent in 1997 to 58 percent in 2001, but they rebounded in 2003 and in 2004, when smoking represented 63 percent of cocaine admissions statewide (exhibit 8). The percentages of clients who inhale cocaine have been steadily increasing from 19 percent in 1997 to 26 percent in 2001 and 28 percent in 2004. Demographic data on cocaine admissions, statewide, for FY 2004 are shown in exhibit 8. Whites accounted for the largest percentage of cocaine admissions in 2004 (46 percent) and 2003 (45 percent), representing a small decline from 2000 (48 percent). Hispanic cocaine admissions increased dramatically from 19 percent in 1997 to 29 percent in 2000 and 30 percent in 2004. African-American cocaine admissions dropped sharply from 33 percent in 1997 to 20 percent in 2001; they then mildly increased in 2003 (24 percent) and then declined in 2004 to 21 percent. Crack cocaine, however, is fairly well entrenched in the African-American urban communities. African- American percentages for all other drugs remain in single digits, with the exception of marijuana (13 percent). In 1997, 56 percent of cocaine admissions were younger than 35; this decreased to 50 percent in 2003 and rebounded to 57 percent in 2004. The majority (69 percent) of 2004 cocaine admissions were between the ages of 26 and 45. Nineteen percent of cocaine admissions in 2004 were younger than 18, and only 12 percent were older than 45. Cocaine admissions remain predominately male, with their proportion growing slightly from 1997 (57 percent male) to FY 2004 (61 percent). Sixty-nine percent were admitted to treatment for cocaine dependence, and 26 percent were admitted for abuse. Thirtyfive percent of cocaine users indicated they used alcohol as a secondary drug, and 24 percent used marijuana. Treatment providers indicated that marijuana is commonly used with cocaine to decrease the effects of withdrawal and to increase the effects of the cocaine. In Federal FY 2002, 34 percent of those sentenced to Federal correctional systems in Colorado had drugs as their primary offense category, compared with 41 percent nationally. Of the 34 percent, powder and crack cocaine were each involved in 18 percent. Thirty-one percent were sentenced because of drug trafficking. EPIDEMIOLOGIC TRENDS IN DRUG ABUSE—Denver and Colorado According to the most recent ADAM data for a sample of Denver arrestees, 35.4 percent of males and 46.5 percent of females had cocaine-positive urine samples in 2001. These numbers were down slightly in 2002, with 32.7 percent of males and 43.6 percent of females testing positive. However, in 2003, 38.3 percent of males and 52.5 percent of females tested positive for cocaine. NFLIS data show that cocaine accounted for 49 percent of all drugs seized by law enforcement and submitted to a forensic laboratory for analysis in Colorado in 2003. According to the National Drug Intelligence Center, powder cocaine is readily available throughout the State, and crack cocaine is more available in urban population centers. In general, Whites prefer powder cocaine and African-Americans prefer crack. Cocaine is the drug most often associated with violent crime in Colorado. The ONDCP reported that the Denver police made 1,234 cocaine arrests per 100,000 city residents between 1996 and 2000. This was more than twice the national average, and 93 percent of these arrests were for possession. The majority of cocaine is Mexican, and it is imported into Colorado by organized Mexican nationals or family groups who have connections to gangs on the west coast. In the last year, two significant drug organizations began to compete to control the wholesale supply. They transport cocaine from the Mexican border or from western States such as California and Arizona to Denver, using automobiles with hidden compartments, commercial and cargo airlines, delivery services, and other mail carriers. Denver serves as a major distribution center for cocaine for the entire country, especially the Midwest and east coast States. Proceeds from cocaine sales are transported to Mexico or the western States via the same means. In Colorado, street distribution is controlled by gangs. There are more than 10,000 gang members in the Denver area, with an average of 1,500 new members added each year. According to the Denver DEA and treatment providers, gangs also control the market for distribution of cocaine in the southern, northern, and western slope areas of the State. Gangs are ubiquitous throughout Colorado, but they are less dominant in the eastern region, where the population is much less dense. In the third quarter of Federal FY 2003 and in the second quarter of 2004, powder cocaine sold for $16,000–$19,000 per kilogram and $700–$1,000 per Proceedings of the Community Epidemiology Work Group, Vol. II, January 2005 67
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NATIONAL INSTITUTE ON DRUG ABUSE EP
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Foreword This publication includes
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EPIDEMIOLOGIC TRENDS IN DRUG ABUSE
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2 EPIDEMIOLOGIC TRENDS IN DRUG ABUS
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Epidemiology of Drug Abuse: CEWG Ar
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• The city of Atlanta has become
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In the first 6 months of 2004, trea
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eports (exhibit 2), while African-A
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population) than in 2002 (17.2 per
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Page 26 and 27: data from the Drug Abuse Warning Ne
Page 28 and 29: than age 18, compared to 4 percent
Page 30 and 31: More often than not, marijuana use
Page 32 and 33: Solomon, L.; Flynn, C.; Muck, K.; e
Page 44 and 45: • Logan International Airport and
Page 46 and 47: In 2002, heroin/morphine was indica
Page 48 and 49: The FY 2004 racial distribution for
Page 58 and 59: • Emergency department (ED) drug
Page 60 and 61: monly mentioned secondary drug amon
Page 62 and 63: Between 2001 and 2003, the Illinois
Page 64 and 65: In the NIHU Study, 20 percent of pa
Page 66 and 67: Ecstasy remained available in most
Page 74 and 75: ounce in the Denver metropolitan ar
Page 76 and 77: 18 at the time of admission to trea
Page 78 and 79: Injecting had been the most common
Page 80 and 81: alcohol; 651 involved alcohol-in-co
Page 90 and 91: The economy in Hawai'i, after a dec
Page 92 and 93: Methamphetamine remains the leading
Page 94 and 95: methamphetamine, representing 76.5
Page 96 and 97: Of interest in this chart is the ag
Page 104 and 105: 98 weighted DAWN data released by S
Page 106 and 107: A total of 5,425 cocaine arrests wa
Page 108 and 109: data, however, rising from 1.5 perc
Page 110 and 111: According to NDIC, California and M
Page 112 and 113: and 15 items were identified as pse
Page 114 and 115: most frequently reported secondary
Page 116 and 117: esidents are living with advanced H
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116 EPIDEMIOLOGIC TRENDS IN DRUG AB
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(DAWN) that monitors emergency depa
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Beginning in 2003, SAMHSA’s natio
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65 percent were older than 34. The
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the 1,198 drug abuse ED reports in
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“Crystal” or smokeable methamph
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tion was injection (62.9 percent),
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included reports of ED cases involv
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From November 10 to 16, 2004, 18 me
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NFLIS between October 2003 and Sept
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from 12.2 percent in the first half
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156 2003. Anecdotal information on
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Brownsville, and El Paso. African-A
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ground economy, it was estimated th
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According to street interviews, mos
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that crack sells for about $28,000-
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Benloton, X-man, 911, Lean Back, Se
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DAWN ME mentions for marijuana-invo
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ecstasy. MDMA ED mentions may be st
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the deaths, while Whites constitute
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2000 reported that the average hero
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for this drug, making olanzapine th
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ADHS/DBHS reported that more than o
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Marijuana is widely available in Ar
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212 2004. Data from 2000-2002 DAWN
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purity dropped to 14.4 percent in 2
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No recent GHB incidents or deaths w
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correspond to decreases in total ad
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228 reports in drug-related visits;
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Marijuana Arrests for marijuana-rel
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positivity. UHS staff believe, on t
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236 are not estimates for the repor
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were evident. Excluding missing dat
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The characteristics of other opiate
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June 2004 (exhibit 6c). A minority
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Deaths involving depressants were a
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imipramine) are an older class of m
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The term “lag” refers to the pe
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costs $1,200-$1,500, compared with
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ties. In the DFW area, Mexican mari
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The 2004 secondary school survey re
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nio and two 2-ounce bottles cost $1
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age may be partially due to the fac
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York and Miami (Pach et al. 2002).
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In 2003, heroin was the primary sub
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opolitan Police Department report t
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International Report
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Among GTC patients, marijuana was t
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Others (63.8 percent) were using a
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Panel on Methamphetamine Abuse: NID
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Appendix A New Drug Abuse Warning N
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DAWN LIVE! The new DAWN includes ca
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Participant List National Institute
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Janie B. Dargan, M.S.W. Policy Anal
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Martin P. Paulus, M.D. Associate Pr
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